{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STACY   D SHOCKLEY","gend":1,"add":"111 5TH STREET NE","city":"PULASKI                       ","state":"VA","zip":"24301-4609","dob":"1981-07-29","age":"","mstatus":"","insh":6882618,"cliId":"","pno":5409706479,"cno":"","email":"","ename":"","eno":"","pphy":"KAATZ, MATTHEW S","ppno":5409800550,"pcpadd":"101 1st St NW,","pcpcity":"PULASKI                       ","pcpstate":"VA","pcpzip":243015603,"pcpcounty":"","pcpid":"","pcpname":"KAATZ MATTHEW S MD PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"111 5TH STREET NE","add3":"","madd1":"111 5TH STREET NE","madd2":"APARTMENT 2","madd3":"","mcity":"PULASKI                       ","mstate":"VA","mzip":"24301-4609","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L72.3","F17.200","C22.1","E66.9","E87.6","F11.10","F10.20","K59.00","Z68.36","Z87.11","Z90.49","Z98.51","K29.70","R10.11","R10.13","R94.5","R10.9","K85.10","D64.9","K80.50","R17","K83.8","K83.1","D72.829","I10","R74.8","R93.2","K29.50","K31.89","B96.81","K80.51","K85.90","F11.20","A04.8","K29.40","Z98.890","Z86.19","Z46.59","K44.9","T18.3XXS","K80.40","Z11.59","T18.3XXA","M17.0","M25.561","F17.210","M79.89","W19.XXXA","Z00.00","R60.0","N94.6","R19.7","H10.9"],"date":["2020-03-06","2020-07-07","2020-03-10","2020-03-13","2020-03-11","2020-03-13","2020-03-10","2020-03-13","2020-03-10","2020-03-10","2020-05-15","2020-03-10","2020-07-09","2020-03-10","2020-07-09","2020-03-13","2020-03-12","2020-03-11","2020-03-20","2020-07-09","2020-03-12","2020-07-09","2020-03-20","2020-03-13","2020-03-13","2020-03-13","2020-03-13","2020-07-09","2020-07-09","2020-07-09","2020-03-20","2020-07-09","2021-01-25","2020-04-20","2020-04-20","2020-05-15","2020-05-15","2020-07-07","2020-07-09","2020-07-07","2020-07-07","2020-07-07","2020-07-09","2021-04-12","2021-04-12","2021-04-12","2021-04-12","2021-04-12","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-07-22"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","10702000350","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","71093012105","GABAPENTIN","CAP 300MG","120","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","62756097083","BUPREN\/NALOX","SUB 8-2MG","56","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","28","Select","Select",""],["","65862022660","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","56","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}